论文部分内容阅读
目的:探讨后腹腔镜肾盂输尿管切开取石术治疗ESWL后输尿管上段石街并肾盂结石的疗效。方法:回顾分析我院2007年3月~2013年12月间行后腹腔镜肾盂输尿管切开取石术治疗ESWL后输尿管上段石街并肾盂结石患者的临床资料,左侧18例,右侧12例;年龄16~72岁,平均40.5岁;石街均位于输尿管上段,距肾盂输尿管连接部约1.0~4.5cm,结石大小0.3~1.6cm,平均0.9cm;肾盂结石大小2.6~5.2cm,平均3.7cm;术前均曾行ESWL 2~12次,平均4次;ESWL后排石时间大于2周,平均3.8周。结果:30例均手术成功,手术时间70~150min,平均90min;术中出血量20~50ml,平均30ml;住院时间6~10d,平均7.5d;术后随访3个月~2年,所有患者肾功能均得到改善,无结石复发及输尿管狭窄发生。结论:后腹腔镜肾盂输尿管切开取石能一次手术同时解决输尿管和肾盂结石问题,具有创伤小、恢复快、住院时间短等优点,可作为ESWL后输尿管上段石街并肾盂结石的首选治疗方法。
Objective: To investigate the effect of retroperitoneoscopic ureteropelvic lithotripsy in the treatment of upper ureteral stone street and renal pelvis after ESWL. Methods: A retrospective analysis of our hospital from March 2007 to December 2013 after laparoscopic ureteropelvic lithotomy for ESWL after upper ureteral stone street and pelvis patients, the clinical data of 18 cases left and right in 12 cases ; Aged 16 to 72 years old, average 40.5 years old; Stone Street are located in the upper ureter, from the ureteropelvic junction about 1.0 ~ 4.5cm, stone size 0.3 ~ 1.6cm, average 0.9cm; renal pelvis size 2.6 ~ 5.2cm, an average of 3.7 cm; preoperative ESWL were performed 2 to 12 times, an average of 4 times; ESWL back row more than two weeks, an average of 3.8 weeks. Results: All the 30 cases were operated successfully, the operation time was 70 ~ 150min, the average was 90min; the blood loss was 20 ~ 50ml, the average was 30ml; the length of hospital stay was 6 ~ 10d, averaged 7.5d; all cases were followed up for 3 months to 2 years Renal function was improved without recurrence of stones and ureteral stricture. Conclusions: Retroperitoneoscopic ureteropelvic pyelolithotomy can solve the problems of ureter and renal pelvis in one operation. It has the advantages of less trauma, faster recovery and shorter hospital stay. It can be used as the first choice for the treatment of upper ureteral stone and renal pelvis after ESWL.